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Sports-related extensor carpi ulnaris pathology: a review of functional anatomy, sports injury and management
  1. Doug Campbell1,
  2. Rob Campbell2,
  3. Phil O'Connor3,
  4. Roger Hawkes4
  1. 1Department of Orthopaedic Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  2. 2Department of Radiology, Royal Liverpool University Hospital, Liverpool, UK
  3. 3Leeds Musculoskeletal Biomedical Research Unit (LMBRU), Department of Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  4. 4European Tour Performance Institute, European Tour, Surrey, UK
  1. Correspondence to Dr Roger Hawkes, European Tour Performance Institute, European Tour, Wentworth Drive Virginia Water, Surrey GU25 4LX, UK; RAH{at}


The extensor carpi ulnaris (ECU) muscle plays a key role not only in the active movements of wrist extension and ulnar deviation but also in providing stability to the ulnar side of the wrist. Its position relative to the other structures in the wrist changes with forearm pronation and supination. As such, it must be mobile yet stable. The ECU tendon relies on specific stabilising structures to hold it in the correct positions to perform its different functions. These structures can be injured in a variety of different athletic activities such as tennis, golf and rugby league, yet their injury and disruption is predictable when the mechanics of the ECU and the techniques of the sport are understood. The ECU tendon is also vulnerable to tendon pathologies other than instability. It lies subcutaneously and is easily palpated and visualised with diagnostic ultrasound, allowing early diagnosis and management of its specific conditions. Treatment includes rest, splintage and surgery with each modality having specific indications and recognised outcomes. This review described the functional anatomy in relevant sporting situations and explained how problems occur as well as when and how to intervene.

  • Wrist Injuries
  • Ultrasound
  • Sporting Injuries
  • Tendons

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